Provider Demographics
NPI:1902590375
Name:MIND ALIGN LLC
Entity Type:Organization
Organization Name:MIND ALIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:MONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC, FPA
Authorized Official - Phone:847-254-6195
Mailing Address - Street 1:760 MCARDLE DR STE D
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8149
Mailing Address - Country:US
Mailing Address - Phone:847-254-6195
Mailing Address - Fax:
Practice Address - Street 1:760 MCARDLE DR STE D
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8149
Practice Address - Country:US
Practice Address - Phone:847-254-6195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty